cardio pulm guy here: the nicotine is the culprit.

Nicotine shuts off your lungs cleaning system (them mucociliary elevator). <-That causes COPD or CA eventually as cells and alveoli get damaged.

They use those other additives for clean burn. And the pre-process ammonia treatment leeches the desired amount of nicotine out for different brands (brands are based on nicotine level).

Micro holes in paper are made to regulate intake and lends to addictive properties.

The industry IS trying to kill you, but slowly.